Dollar Store Groceries Linked to Higher Rates of Obesity, Diabetes and Other Health Problems

Dollar store groceries may reduce the bill for shoppers across the US, but living in areas with greater access to outlets including Dollar General, Dollar Tree, Family Dollar and the 99 Cent Store was associated with higher rates of obesity, high blood pressure, high cholesterol and type 2 diabetes, according to a UC Riverside-led study published on 18 June 2026.

The research, published in BMC Public Health, compared access to dollar stores with access to traditional grocery shops in metropolitan areas across the contiguous US.

The associations remained after researchers accounted for social vulnerability, including economic factors such as income and unemployment that may influence health and access to food.

How Dollar Store Groceries Were Assessed

Dollar stores are classified by the US Census Bureau as general merchandise outlets rather than grocery stores. That distinction means they have often been left out of research examining the country's food environment, even though many shoppers buy food there.

Ryan Bruellman, the study's first author and a doctoral student in genetics, genomics and bioinformatics at UC Riverside, examined data from the Centers for Disease Control and Prevention's 500 Cities Project.

The data covered major metropolitan areas and cities across the continental US, including greater Los Angeles and California's Inland Empire.

The researchers mapped the locations of traditional grocery shops and dollar stores, then assessed how many were within a 10-minute drive of residential areas.

They also incorporated the CDC's Social Vulnerability Index, which includes socioeconomic factors such as income, unemployment and access to transport.

The study used store-location data from 2016 to 2020 and health estimates from the CDC's 2019 500 Cities release, which drew on 2016 and 2017 estimates.

Crucially, the findings identify neighbourhood-level associations between store access and health outcomes; they do not establish that individuals who shop at dollar stores develop disease as a result.

Still, the researchers identified a consistent national pattern. Proximity to traditional grocery shops was associated with lower rates of obesity, diabetes and high blood pressure.

Access to dollar stores, classified in the research as low-quality food outlets, showed positive associations with the adverse health outcomes studied nationally, even after researchers accounted for social vulnerability.

'Across the US there are more dollar stores than traditional grocery stores,' Bruellman said, underlining how far these outlets sit outside the margins of America's food system.

Together, Dollar General, Dollar Tree, the 99 Cent Store and Family Dollar represented about 34,000 locations in the researchers' dataset. For households dealing with rising food prices, these shops can be among the most accessible places to buy something for dinner, even if the available choice is narrow.

Why Dollar Store Groceries Matter

Bruellman said the issue was not simply that shoppers were choosing cheap food. He pointed instead to the quality and composition of what is available.

'I want to raise awareness that higher grocery costs are pushing people to buy highly processed, lower quality food at dollar stores, and it is negatively impacting their health in a similar way to fast food,' he said.

Traditional grocery stores generally offer broader access to foods such as fresh fruits, vegetables, whole grains and lean proteins, while the researchers classified dollar stores as lower-quality food sources based on differences in typical healthy-food offerings.

However, the study did not track what individual residents bought or ate, meaning it cannot establish that dollar-store food itself caused the health outcomes identified in the analysis.

The strength of the relationship also varied by region. The researchers found particularly strong associations in parts of the South and Midwest, where dollar stores represented a substantial share of accessible food outlets.

Bruellman suggested that the higher number of outlets in those regions could help explain the difference. The findings were not identical in every city.

Local food environments can include independent shops and other sources that were not fully represented in the researchers' dataset. That limitation is important because a map can show where a major chain is located without showing every place where residents actually buy food.

The study does not call for dollar stores to disappear. Bruellman argued that removing them would risk cutting off a vital source of affordable food without solving the underlying problem.

His proposed answer is more practical, if harder to deliver. Dollar stores could partner with local farmers to bring fresh produce into neighbourhoods where healthier choices are limited.

Cities could also support farmers' markets and food banks closer to existing discount outlets, rather than placing them somewhere residents cannot easily reach.

'Ideally you'd have the healthier options available inside the dollar store,' Bruellman said.That suggestion shifts the debate away from blaming shoppers for buying what they can afford. It also raises a bigger question about food policy.

If discount retailers function as grocery shops in everyday life, the researchers argue that food-environment research and policymaking should account for both their presence and the quality of food they offer.

The study therefore does not show that a cheap grocery bill inevitably produces a larger health bill. Instead, it suggests that the type and quality of food available in a neighbourhood may be an important part of understanding disparities in cardiometabolic health.